Endothelial Progenitor and Mesenchymal Stromal Cells in Newborns With Congenital Diaphragmatic Hernia Undergoing Extracorporeal Membrane Oxygenation

Frontiers in Pediatrics

article

Neysan Rafat¹  Christian Patry²  Ursula Sabet²  Tim Viergutz⁴  Christel Weiss⁵  Burkhard Tönshoff²  Grietje Beck⁶  Thomas Schaible¹ 

[1] Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg;Department of Pediatrics I, University Children's Hospital Heidelberg;Department of Pharmaceutical Sciences, Bahá'í Institute of Higher Education (BIHE);Department of Anesthesiology and Critical Care Medicine, University Medical Center Mannheim, University of Heidelberg;Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg;Department of Anesthesiology, Helios Dr. Horst-Schmidt Clinic

关键词: progenitor cells;    stem cells;    ECMO;    congenital diaphragmatic hernia;    neonates;   

DOI  :  10.3389/fped.2019.00490

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Endothelial progenitor (EPC) and mesenchymal stromal cells (MSC) can regenerate damaged endothelium and thereby improve pulmonary endothelial dysfunction. We do not know, how extracorporeal membrane oxygenation (ECMO) might affect EPC- and MSC-mediated regenerative pathways in patients with congenital diaphragmatic hernia (CDH). Therefore, we investigated, if ECMO support impacts EPC and MSC numbers in CDH patients. Methods: Peripheral blood mononuclear cells from newborns with ECMO-dependent ( n = 18) and ECMO-independent CDH ( n = 12) and from healthy controls ( n = 12) were isolated. The numbers of EPC and MSC were identified by flowcytometry. Serum levels of vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-2 were determined. Results: EPC and MSC were elevated in newborns with CDH. ECMO-dependent infants had higher EPC subpopulation counts (2,1–7,6-fold) before treatment compared to ECMO-independent infants. In the disease course, EPC and MSC subpopulation counts in ECMO-dependent infants were lower than before ECMO initiation. During ECMO, VEGF serum levels were significantly reduced (by 90.5%) and Ang2 levels significantly increased (by 74.8%). Conclusions: Our data suggest that ECMO might be associated with a rather impaired mobilization of EPC and MSC and with a depression of VEGF serum levels in newborns with CDH.

【 授权许可】

CC BY